1
|
Roriz VM, Santana M, Boaventura VL, Zanotto ED, Peitl Filho O, Dias DR. Efficacy of Biosilicate Glass-ceramic and Fluoride Varnish in the Treatment of Dentin Hypersensitivity-A Randomized Controlled Clinical Trial. Oper Dent 2024; 49:253-261. [PMID: 38632860 DOI: 10.2341/23-077-c] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 11/12/2023] [Indexed: 04/19/2024]
Abstract
OBJECTIVE The objective of this study was to compare the efficacy of Biosilicate and Duraphat in the treatment of dentin hypersensitivity (DH). METHODS AND MATERIALS This clinical trial was conducted with young adults presenting DH. A visual analogue scale (VAS) was used to assess the level of pain, using volatile and tactile tests. Forty participants presenting two teeth with DH were included, and these teeth were divided into two groups according to the treatment: Biosilicate or Duraphat. Each product was randomly applied on one tooth per participant once a week for 4 weeks and evaluated every 15 days for 60 days after the last application. RESULTS The mean and standard deviation (SD) of VAS values for the initial volatile sensitivity evaluation were 6.18 (1.99) and 6.08 (1.98) for the Biosilicate and Duraphat groups, respectively, and at the fourth week 0.48 (1.5) and 0.83 (1.58). After 60 days, the volatile sensitivity showed the following values: 0.63 (1.19) for Biosilicate and 1.03 (1.07) for Duraphat. The intragroup comparison showed a significant reduction of mean VAS values for DH-related pain assessed by volatile testing for both groups (p<0.001), and the assessment at the 60-day follow-up showed mean values statistically similar to those obtained at the end of treatment. Initial tactile sensitivity observed was 1.48 (2.39) for the Biosilicate and 1.4 (2.2) for the Duraphat group and at the 60-day follow-up 0.23 (0.73) and 0.15 (0.36), respectively, with significant statistical difference (p<0.002). When the reduction in tactile and volatile sensitivities between both groups was compared, no statistically significant difference was observed. CONCLUSION This study indicated that both products were able to promote an important reduction in dentin hypersensitivity with similar results within a 60-day follow-up.
Collapse
Affiliation(s)
- V M Roriz
- Virgílio Moreira Roriz, adjunct professor, Periodontology, Dentistry School, Federal University of Goias, Goiania, Goias, Brazil
| | - Mll Santana
- Maria Luiza Lima Santana, MDSc, Federal University of Goias, Goiania, Goias, Brazil
| | - V L Boaventura
- Verônica Lima Boaventura, private clinical practice, Anápolis, Goias, Brazil
| | - E D Zanotto
- Edgar Dutra Zanotto, full professor, Department of Materials Engineering, Federal University of São Carlos, São Carlos, São Paulo, Brazil
| | - O Peitl Filho
- Oscar Peitl Filho, full professor, Department of Materials Engineering, Federal University of São Carlos, São Carlos, São Paulo, Brazil
| | - D R Dias
- *Danilo Rocha Dias, adjunct professor, Department of Restorative Dentistry, Dentistry School, Federal University of Minas Gerais, Belo Horizonte, Minas Gerais-Brazil
| |
Collapse
|
2
|
Naghsh N, Hosseini A, Bazmara A, Birang R. Evaluation of Three Methods for the Treatment of Dentin Hypersensitivity: A Randomised Clinical Trial. Int Dent J 2024:S0020-6539(24)00098-4. [PMID: 38614879 DOI: 10.1016/j.identj.2024.03.013] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/02/2023] [Revised: 02/23/2024] [Accepted: 03/20/2024] [Indexed: 04/15/2024] Open
Abstract
OBJECTIVES In this study, we aimed to compare the effectiveness of Gluma and high-power 980-nm diode laser, alone or in combination, in the treatment of cervical dentin hypersensitivity. METHODS A total of 20 patients (5 men and 15 women), aged 25 to 60 years, who met the inclusion criteria, were enrolled in this study. A total of 60 teeth were randomly divided into 4 groups: G1, 980 nm diode laser (in 2 sessions within a 1-week interval); G2, Gluma (in 2 sessions within a 1-week interval); G3, 980 nm diode laser plus Gluma; and G4: control. Thermal (cold spray) and air blast (air syringe of dental unit) stimuli were used to evaluate cervical dentin hypersensitivity in the patients. Their pain response was assessed using a visual analogue scale (VAS) before treatment (baseline), in the first treatment session (15 minutes after treatment), in the second treatment session (after 1 week), and in 2-week, 1-month, and 3-month follow-up sessions. The obtained data were analysed using non-parametric tests, including Kruskal-Wallis test, Friedman test, Mann-Whitney test, and Wilcoxon test, in SPSS Version 22 at a significance level of P < .05. RESULTS Based on the results, there was a significant difference in the average VAS scores for cold and air blast stimuli between the 4 groups 1 month after the intervention (P < .05). Meanwhile, the laser group had the lowest VAS score for cold and air stimuli. On the contrary, no significant difference was found between the 4 groups 3 months after the intervention (P ˃ .05). CONCLUSION The present results showed that 980-nm diode laser alone was more effective than the other 2 intervention methods for 1 month. TRIAL REGISTRATION The study was registered in the Iranian Registry of Clinical Trials (IRCT20120901010703N5).
Collapse
Affiliation(s)
- Narges Naghsh
- Department of Periodontology, Dental Implants Research Center, Dental Research Institute, School of Dentistry, Isfahan University of Medical Sciences, Isfahan, Iran.
| | - Arezoo Hosseini
- Dental Students' Research Committee, School of Dentistry, Isfahan University of Medical Sciences, Isfahan, Iran
| | - Azin Bazmara
- Dental Students' Research Committee, School of Dentistry, Isfahan University of Medical Sciences, Isfahan, Iran
| | - Reza Birang
- Department of Periodontology, Dental Implants Research Center, Dental Research Institute, School of Dentistry, Isfahan University of Medical Sciences, Isfahan, Iran
| |
Collapse
|
3
|
Golriz N, Barekatain M, Mirzakocheki Broujeni P. Penetration and durability of CPP-ACP paste and sodium fluoride varnish as desensitizing agents: An in vitro comparison. J Dent Res Dent Clin Dent Prospects 2023; 17:119-127. [PMID: 37649823 PMCID: PMC10462472 DOI: 10.34172/joddd.2023.28050] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/22/2022] [Accepted: 05/23/2023] [Indexed: 09/01/2023] Open
Abstract
Background This study aimed to investigate and compare the penetration and durability of two dentin desensitizers, sodium fluoride varnish and casein phosphopeptide-amorphous calcium phosphate (CPP-ACP) paste, using electron microscopy. Methods The study was performed on 60 dentin specimens prepared from extracted human premolars. After applying 17% EDTA to remove the smear layer, the specimens were divided into two groups. MI Paste and Bi-fluoride varnish were applied to the specimens. Microscopic images of 20 samples were obtained immediately. Twenty other samples were accessed after 15 days, and the other 20 were accessed after 30 days of toothbrushing and thermal cycling. Both surface and longitudinal cross-sectional images (after sample fracture) were studied. Data were analyzed with two-way ANOVA and Mann-Whitney U test at a significance level of P<0.05. Results The mean depth of material penetration was significantly time-dependent and fluctuated in both groups. There was a significant difference between the mean level of plugs between 0, 15, and 30 days (P<0.001). Penetration increased with time for the MI Paste group, while in the Bi-fluoride group, the increase was significant at 15 and 30 days than immediately after application. The mean thickness of the plugs was significantly different at the three time periods, and MI Paste showed a sudden decrease in plug thickness after 15 days. Conclusion Immediately after application, Bi-fluoride occluded dentinal tubules more effectively, and its durability after abrasion and thermal fatigue were higher than MI Paste.
Collapse
Affiliation(s)
| | - Mehrdad Barekatain
- Department of Operative Dentistry, Isfahan (Khorasgan) Branch, Islamic Azad University, Isfahan, Iran
| | | |
Collapse
|
4
|
Siddig RE, Ellateef AEAA, Awooda EM. Impact of the combined effect of diode laser (976 nm) and Sodium Fluoride gel in the Treatment of Dentin Hypersensitivity: An Ex Vivo Study.. [DOI: 10.21203/rs.3.rs-2358206/v1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 09/01/2023]
Abstract
Abstract
Background: Dentin Hypersensitivity (DH) is a painful condition with challenging treatment options.
Aims: This study aims to evaluate the effects of the diode laser on dentinal tubules by a diode laser, as well as the mechanism of the diode laser (976 nm) and chemical agent (sodium fluoride gel) in occluding the dentinal tubules in vitro.
Materials and Methods: Ten extracted human premolars were utilized in the current in vitro experimental SEM study. Using a diamond saw at a coronal dentin, disks of 1.0 mm thickness were cut perpendicular to the long axis of each tooth. Ten dentin disks were selected, and each disk was divided into four equal parts, pre-treated with Ethylene Diamine Tetra Acetic Acid 17%, then divided into four groups; (Group 1) control, (Group 2) diode laser 976 nm of 1 watt, (Group 3) Sodium fluoride only and (Group 4) combined laser and sodium fluoride varnish. The samples were analyzed using a scanning electron microscope at different magnifications (100µm, 50µm, 20µm, and 2µm). ANOVA Test was used to compare the diameter of the tubules and area between the four groups, with the level of significance set at a p-value of ˂0.05.
Results: Group 1 (control, no treatment) showed an opening of all the dentinal tubules. Both samples of Group 2 (laser) and Group 3 (Sodium Fluoride) demonstrated partial occlusion and narrowing of most dentinal tubules, while Group 4 (combined) showed total occlusion of almost all the dentinal tubules. There is a statistically significant difference between the four groups regarding the diameter of the dentinal tubules and the area of 5×5 mm diameter on the dentin disks.
Conclusions: The combination of Diode laser (976 nm) 1W and sodium fluoride varnish significantly affected the dentinal tubule occlusion, thus preventing DH.
Collapse
|
5
|
Okur E, Eyüboğlu GB. Evaluation of Dentin Tubule Plugging Efficiencies and Effects on Dentin Surface Roughness of Dentin Desensitizing Agents, the Er,Cr:YSGG Laser, and Their Combination After Erosion-Abrasion Cycles: An In Vitro Study. Oper Dent 2022; 47:E35-E51. [PMID: 35289911 DOI: 10.2341/21-086-l] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 08/29/2021] [Indexed: 11/23/2022]
Abstract
OBJECTIVES The purposes of this in vitro study were to evaluate the tubule plugging efficiencies and effects on the surface roughness of dentin of different dentin desensitizing agents (DDAs; Teethmate Desensitizer, Kuraray; Gluma Desensitizer, Kulzer; Clinpro White Varnish, 3M ESPE; Enamelast, Ultradent) and the Er,Cr:YSGG laser (Biolase, Waterlase), both alone and in combination with DDAs, after application and after an erosion-abrasion cycle. METHODS AND MATERIALS For surface roughness examinations, superficial buccal dentin specimens were divided into 10 groups: the control, Teethmate Desensitizer, Gluma Desensitizer, Enamelast, Clipro White Varnish, Er,Cr:YSGG Laser, Teethmate Desensitizer-Laser, Gluma Desensitizer-Laser, and Enamelast-Laser, and Clinpro White Varnish-Laser groups. Profilometric analyses and scanning electron microscopy (SEM) examinations were performed after applications and after a 5-day erosive-abrasive cycle. For the statistical analysis of surface roughness measurements, 2-way analysis of variance (ANOVA), 1-way ANOVA, and Tukey post hoc test were used. RESULTS Among the treatments, only DDAs alone did not cause increase in surface roughness after application. All of the laser applications increased the surface roughness of dentin, and after the erosion-abrasion cycle, all of the test groups had increased surface roughness. However, SEM images showed that morphological changes were less frequently observed in all of the experimental groups than in the control group. In addition, all of the laser-DDA combinations had stronger tubule occlusion effects than did DDAs alone, even after erosion-abrasion. CONCLUSIONS All of the test treatments showed protective effects on dentin surfaces against the negative effects of erosion-abrasion. The addition of the laser to DDA applications increased tubular plugging efficiencies of DDAs, and the tubule plugs of the combination treatments were resistant to the erosion-abrasion cycle.
Collapse
Affiliation(s)
- E Okur
- Esmahan Okur, Dr Dt, Department of Restorative Dentistry, School of Dentistry, Karadeniz Technical University, Ortahisar/Trabzon, Turkey
| | - G B Eyüboğlu
- *Güneş Bulut Eyüboğlu, DDS, PhD, Department of Restorative Dentistry, School of Dentistry, Karadeniz Technical University, Ortahisar/Trabzon, Turkey
| |
Collapse
|
6
|
BULUT EYÜBOĞLU G, SERİN KALAY T. THE EFFECTS OF SODIUM FLUORIDE, PROPOLIS, ER,CR:YSGG LASER AND THEIR COMBINATIONS ON DENTIN TUBULES AND SHEAR BOND STRENGTH TO DENTIN. CUMHURIYET DENTAL JOURNAL 2022. [DOI: 10.7126/cumudj.1032878] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022] Open
|
7
|
Shan Z, Ji J, McGrath C, Gu M, Yang Y. Effects of low-level light therapy on dentin hypersensitivity: a systematic review and meta-analysis. Clin Oral Investig 2021; 25:6571-6595. [PMID: 34642786 PMCID: PMC8602177 DOI: 10.1007/s00784-021-04183-1] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/15/2021] [Accepted: 09/18/2021] [Indexed: 01/08/2023]
Abstract
OBJECTIVE To investigate the treatment efficacy of low-level light therapy on dentin hypersensitivity. MATERIALS AND METHODS Following the PRISMA guideline, six electronic databases supplemented with bibliographies were searched till December 2020. Two reviewers performed the screenings independently with a reliability assessment. Studies fulfilling the pre-registered eligibility criteria were included for risk-of-bias assessment and data synthesis. RESULTS Thirty-five articles ultimately informed this systematic review based on the eligibility criteria and underwent risk-of-bias assessment (ĸ = 0.86). Quantitative results were deduced by meta-analysis of 20 randomised controlled trials: LLLT showed favourable outcomes compared to placebos for immediate (SMD: 1.09, 95% CI: 0.47 to 1.70), interim (SMD: 1.32, 95% CI: 0.41 to 2.23), and persistent efficacies (SMD: 2.86, 95% CI: 1.98 to 3.74). However, substantial heterogeneity existed among included studies (I2: 64-95%). Regarding comparisons with other desensitising strategies, LLLT showed no significant benefits in DH alleviation over others except fluorides for interim efficacy (SMD: 0.31, 95% CI: 0.10 to 0.52) and persistent efficacy (SMD: 0.45, 95% CI: 0.03 to 0.86). CONCLUSIONS This systematic review shows that LLLT has positive immediate, interim, and persistent DH-treatment efficacies compared with placebo. No superior treatment effects of LLLT were observed except fluoride agent use. Further studies are warranted-RCTs with low risk of bias, consistent technical settings, comprehensive assessments, and long follow-up periods. CLINICAL RELEVANCE This systematic review bridges a critical research gap by analysing clinical evidence in the DH-alleviating efficacy of LLLT in comparison with placebo and other in-office desensitising strategies.
Collapse
Affiliation(s)
- Zhiyi Shan
- Faculty of Dentistry, The University of Hong Kong, 34 Hospital Road, Sai Ying Pun, Hong Kong SAR, China
| | - Juanjuan Ji
- Faculty of Dentistry, The University of Hong Kong, 34 Hospital Road, Sai Ying Pun, Hong Kong SAR, China
- Department of Stomatology, Second People's Hospital of Yunnan Province, Kunming, People's Republic of China
| | - Colman McGrath
- Faculty of Dentistry, The University of Hong Kong, 34 Hospital Road, Sai Ying Pun, Hong Kong SAR, China
| | - Min Gu
- Faculty of Dentistry, The University of Hong Kong, 34 Hospital Road, Sai Ying Pun, Hong Kong SAR, China
| | - Yanqi Yang
- Faculty of Dentistry, The University of Hong Kong, 34 Hospital Road, Sai Ying Pun, Hong Kong SAR, China.
| |
Collapse
|
8
|
Abstract
BACKGROUND Dentinal hypersensitivity is characterized by short, sharp pain from exposed dentine that occurs in response to external stimuli such as cold, heat, osmotic, tactile or chemicals, and cannot be explained by any other form of dental defect or pathology. Laser therapy has become a commonly used intervention and might be effective for dentinal hypersensitivity. OBJECTIVES To assess the effects of in-office employed lasers versus placebo laser, placebo agents or no treatment for relieving pain of dentinal hypersensitivity. SEARCH METHODS Cochrane Oral Health's Information Specialist searched the following databases: Cochrane Oral Health's Trials Register (to 20 October 2020), the Cochrane Central Register of Controlled Trials (CENTRAL) (the Cochrane Library 2020, Issue 9), MEDLINE Ovid (1946 to 20 October 2020), Embase Ovid (1980 to 20 October 2020), CINAHL EBSCO (Cumulative Index to Nursing and Allied Health Literature; 1937 to 20 October 2020), and LILACS BIREME Virtual Health Library (Latin American and Caribbean Health Science Information database; from 1982 to 20 October 2020). Conference proceedings were searched via the ISI Web of Science and ZETOC, and OpenGrey was searched for grey literature. The US National Institutes of Health Ongoing Trials Register (ClinicalTrials.gov) and the World Health Organization International Clinical Trials Registry Platform were searched for ongoing trials. No restrictions were placed on the language or date of publication when searching the electronic databases. SELECTION CRITERIA Randomized controlled trials (RCTs) in which in-office lasers were compared to placebo or no treatment on patients aged above 12 years with tooth hypersensitivity. DATA COLLECTION AND ANALYSIS Two review authors independently and in duplicate screened the search results, extracted data, and assessed the risk of bias of the included studies. Disagreement was resolved by discussion. For continuous outcomes, we used mean differences (MD) and 95% confidence intervals (CI). We conducted meta-analyses only with studies of similar comparisons reporting the same outcome measures. We assessed the overall certainty of the evidence using GRADE. MAIN RESULTS We included a total of 23 studies with 936 participants and 2296 teeth. We assessed five studies at overall low risk of bias, 13 at unclear, and five at high risk of bias. 17 studies contributed data to the meta-analyses. We divided the studies into six subgroups based on the type of laser and the primary outcome measure. We assessed the change in intensity of pain using quantitative pain scale (visual analogue scale (VAS) of 0 to 10 (no pain to worst possible pain)) when tested through air blast and tactile stimuli in three categories of short (0 to 24 hours), medium (more than 24 hours to 2 months), and long term (more than 2 months). Results demonstrated that compared to placebo or no treatment the application of all types of lasers combined may reduce pain intensity when tested through air blast stimuli at short term (MD -2.24, 95% CI -3.55 to -0.93; P = 0.0008; 13 studies, 978 teeth; low-certainty evidence), medium term (MD -2.46, 95% CI -3.57 to -1.35; P < 0.0001; 11 studies, 1007 teeth; very low-certainty evidence), and long term (MD -2.60, 95% CI -4.47 to -0.73; P = 0.006; 5 studies, 564 teeth; very low-certainty evidence). Similarly, compared to placebo or no treatment the application of all types of lasers combined may reduce pain intensity when tested through tactile stimuli at short term (MD -0.67, 95% CI -1.31 to -0.03; P = 0.04; 8 studies, 506 teeth; low-certainty evidence) and medium term (MD -1.73, 95% CI -3.17 to -0.30; P = 0.02; 9 studies, 591 teeth; very low-certainty evidence). However, there was insufficient evidence of a difference in pain intensity for all types of lasers when tested through tactile stimuli in the long term (MD -3.52, 95% CI -10.37 to 3.33; P = 0.31; 2 studies, 184 teeth; very low-certainty evidence). Most included studies assessed adverse events and reported that no obvious adverse events were observed during the trials. No studies investigated the impact of laser treatment on participants' quality of life. AUTHORS' CONCLUSIONS Limited and uncertain evidence from meta-analyses suggests that the application of laser overall may improve pain intensity when tested through air blast or tactile stimuli at short, medium, or long term when compared to placebo/no treatment. Overall, laser therapy appears to be safe. Future studies including well-designed double-blinded RCTs are necessary to further investigate the clinical efficacy of lasers as well as their cost-effectiveness.
Collapse
Affiliation(s)
- Mina Mahdian
- Department of Prosthodontics and Digital Technology, Stony Brook University School of Dental Medicine, Stony Brook, NY, USA
| | - Soodabeh Behboodi
- Faculty of Dentistry, Tabriz University of Medical Sciences, Tabriz, Iran
| | - Yumi Ogata
- Department of Periodontology, Tufts University School of Dental Medicine, Boston, MA, USA
| | - Zuhair S Natto
- Department of Dental Public Health, Faculty of Dentistry, King Abdulaziz University, Jeddah, Saudi Arabia
| |
Collapse
|
9
|
Sgreccia PC, Barbosa RES, Damé-Teixeira N, Garcia FCP. Low-power laser and potassium oxalate gel in the treatment of cervical dentin hypersensitivity-a randomized clinical trial. Clin Oral Investig 2020; 24:4463-4473. [PMID: 32382926 DOI: 10.1007/s00784-020-03311-7] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/20/2020] [Accepted: 04/23/2020] [Indexed: 10/24/2022]
Abstract
OBJECTIVE To evaluate the effectiveness of different protocols for the treatment of cervical dentin hypersensitivity (CDH) in non-carious cervical lesions (NCCLs). MATERIALS AND METHODS The CONSORT checklist was used to design this study. The sample with n = 74 participants (389 NCCLs) was randomly allocated into three groups: G1, potassium oxalate (Oxa-Gel BF); G2, GaAlAs (gallium-aluminum-arsenate) low-power laser (100 mW, 808nn, 60 J/cm2); and G3, potassium oxalate (Oxa-Gel BF) associated with the GaAlAs low-power laser. The CDH was triggered by the evaporative stimulus test (EST) and by the tactile stimulus test (TST). The visual analog scale (VAS) was used to quantify the degree of CDH. Changes in sensitivity were assessed from baseline over 3 weeks. Data were analyzed for NCCLs using mixed-effects models with unstructured direct product covariance structure (α = 0.05). RESULTS After the first application, participants from G1 and G3 had a reduction in CDH (p < 0.05) compared with group G2 for TST. After the second application, G3 participants had a reduction in CDH (p < 0.05) in relation to G2 for both stimuli. Reduction in CDH (p < 0.05) occurred over 3 weeks for EST and TST for all groups; however, there was no difference between groups at the end of the therapies. CONCLUSION Potassium oxalate was more effective in reducing immediate CDH. After four applications, all groups showed similar results for the reduction of CDH. CLINICAL RELEVANCE GaAlAS laser irradiation and oxalate potassium gel could reduce the symptoms of CDH; thus, they are viable alternatives for the treatment of this condition. Chemical occlusion of dental tubules showed effective results after a shorter time interval. TRIAL REGISTRATION Brazilian Clinical Trials Registration Platform under protocol number RBR-4ybjmt. http://www.braziliantrials.com/?keywords=RBR-4ybjmt&order=%7Eensaios.patrocinador_primario.
Collapse
Affiliation(s)
- Paula Cesar Sgreccia
- Faculty of Health Sciences, University of Brasilia, Brasília, Federal District, Brazil
| | | | - Nailê Damé-Teixeira
- Department of Dentistry and Pos Graduate Program in Dentistry, Health Sciences School, University of Brasília, Campus Asa Norte, Brasilia, Federal District, 70904-970, Brazil
| | - Fernanda Cristina Pimentel Garcia
- Department of Dentistry and Pos Graduate Program in Dentistry, Health Sciences School, University of Brasília, Campus Asa Norte, Brasilia, Federal District, 70904-970, Brazil. .,Department of Dentistry and Pos Graduate Program in Dentistry, Health Sciences School for Faculty of Health Sciences, University of Brasília, Campus Asa Norte, Brasilia, Federal District, 70904-970, Brazil.
| |
Collapse
|
10
|
Jain A, Rao J, Pal N, Singh A. Effectiveness of fluoride varnish, diode laser, and their combination in treatment of dentin hypersensitivity: A randomized split-mouth clinical trial. J Indian Soc Periodontol 2020; 24:369-374. [PMID: 32831511 PMCID: PMC7418551 DOI: 10.4103/jisp.jisp_494_19] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/23/2019] [Revised: 12/13/2019] [Accepted: 12/25/2019] [Indexed: 11/04/2022] Open
Abstract
Background: Dentin hypersensitivity is a common dental problem with no permanent cure and predictable prognosis. Aim: The aim of this study was to evaluate the effectiveness of fluoride varnish (sodium fluoride [NaF]), diode laser, and the combination of NaF and diode laser in the treatment of dentin hypersensitivity. Settings and Design: This was a randomized split-mouth clinical trial. Materials and Methods: Sixty patients aged 20–60 years suffering from dentin hypersensitivity to air-blast, cold, and tactile stimulation corresponding to 4 cm and above on the Visual Analog Scale (VAS) in three quadrants with at least two hypersensitive teeth per quadrant were selected. Hypersensitive teeth were allotted to Group 1 – 5% NaF varnish application alone, Group 2 – 810-nm gallium–aluminum–arsenide laser (GaAlAs) diode laser (0.5 W) irradiation alone, and Group 3 – NaF varnish application, followed by diode laser irradiation. VAS score was recorded at baseline, 1 week, 2 weeks, 1 month, 3 months, and 6 months. Results: A statistically significant reduction in dentin hypersensitivity was observed in all the three groups, from the baseline to the 1st-, 3rd-, and 6th-month follow-ups (P < 0.05). Group 2 and Group 3 demonstrated a significantly higher reduction (P < 0.05) in dentin hypersensitivity for all the stimuli as opposed to Group 1 at all follow-up intervals. However, no statistically significant difference (P > 0.05) was present between Group 2 and Group 3 at all follow-ups. Conclusion: Diode laser is significantly more effective than fluoride varnish alone in the treatment of dentin hypersensitivity over a period of 6 months.
Collapse
Affiliation(s)
- Akanksha Jain
- Department of Periodontics, Goa Dental College and Hospital, Bambolim, Goa, India
| | - Jyoti Rao
- Department of Periodontics, Goa Dental College and Hospital, Bambolim, Goa, India
| | - Neha Pal
- Department of Periodontics, Goa Dental College and Hospital, Bambolim, Goa, India
| | - Alok Singh
- Department of Oral Surgery, Saraswati Dental College, Lucknow, Uttar Pradesh, India
| |
Collapse
|
11
|
Muniz RSC, Carvalho CN, Aranha ACC, Dias FMCS, Ferreira MC. Efficacy of low-level laser therapy associated with fluoride therapy for the desensitisation of molar-incisor hypomineralisation: Randomised clinical trial. Int J Paediatr Dent 2020; 30:323-333. [PMID: 31808584 DOI: 10.1111/ipd.12602] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/07/2019] [Revised: 11/23/2019] [Accepted: 12/02/2019] [Indexed: 11/28/2022]
Abstract
BACKGROUND Molar-incisor hypomineralisation (MIH) is a qualitative enamel defect. AIM To investigate the low-level laser therapy (LLLT) associated with fluoride varnish for the desensitisation of teeth with MIH. DESIGN A randomised clinical trial was conducted with 66 children, randomly allocated to the treatments: laser (L); fluoride varnish (FV); and laser + fluoride varnish (L + FV). The participants in the L group underwent two sessions of LLLT (48-hour interval). The FV group received four applications of varnish at one-week intervals. The L + FV underwent two sessions of LLLT and four applications of varnish. Prior to each session and one month after the onset of treatment, tooth sensitivity and its magnitude were evaluated. Intra- and inter-group comparisons were performed (α = 5%). RESULTS A significant reduction in the mean sensitivity score was found over time in all groups. After the final treatment, a significant difference was found between the L and L + FV groups (P = .011), with a lower score in the L + FV group (0.09), whereas no difference was found between the FV and L + FV groups (P = .095). CONCLUSIONS Fluoride varnish and the combination of treatments (L + FV) had greater desensitising action on teeth with MIH. Laser therapy demonstrated an immediate desensitising effect, whereas fluoride varnish had a late-onset effect.
Collapse
Affiliation(s)
| | - Ceci Nunes Carvalho
- School of Dentistry, Postgraduate Program in Dentistry, Ceuma University, São Luís, Brazil
| | - Ana Cecília Correa Aranha
- Department of Restorative Dentistry, School of Dentistry, São Paulo University, São Paulo, SP, Brazil
| | | | - Meire Coelho Ferreira
- School of Dentistry, Postgraduate Program in Dentistry, Ceuma University, São Luís, Brazil
| |
Collapse
|
12
|
Vahdatinia F, Gholami L, Karkehabadi H, Fekrazad R. Photobiomodulation in Endodontic, Restorative, and Prosthetic Dentistry: A Review of the Literature. PHOTOBIOMODULATION PHOTOMEDICINE AND LASER SURGERY 2019; 37:869-886. [PMID: 31873065 DOI: 10.1089/photob.2019.4707] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
Abstract
Objective: To provide a review of the literature about the photobiomodulation therapy (PBMT) dental treatment protocols in endodontic, restorative, and prosthetic dentistry based on validated clinical studies published so far. More specifically, this study was carried out to carefully review therapeutic protocol of PBMT in clinical studies and their conclusions. Background data: The importance of using low-power lasers and photobiomodulation (PBM) is increasing in dentistry mainly due to their painless and noninvasive function. However, lack of sufficient clinical studies has led to unclear results regarding PBMT in dentistry, and also lack of an available precise protocol for clinicians. Moreover, scarcity of clinical studies in this area has made conduction of a precise systematic review study difficult. Methods: In our study, published clinical studies up to April 2019 were reviewed from library sources, Google Scholar, PubMed and Medline, Elsevier, Embase, Cochrane, Scopus, and Web of science (ISI). Inclusion criteria included those presented in clinical trials and case report/case series, language (English), and studies available in full text. Exclusion criterion was in vitro studies. Results: In general, findings of clinical studies have shown that PBMT can have a significant role in reducing postoperative dental pain, increasing depth of anesthesia, improving tooth hypersensitivity, reducing inflammation of the tissue, and helping wound healing. Conclusions: A review of clinical studies showed that the use of alternative or adjunctive PBMT is of great importance in controlling postoperative pain after endodontic treatments. In addition, evidence suggests that different parameters of light can be efficient in the treatment of tooth hypersensitivity. Nevertheless, lack of sufficient clinical studies and reliable results do not allow introducing a precise treatment protocol.
Collapse
Affiliation(s)
- Farshid Vahdatinia
- Dental Implants Research Center, Hamadan University of Medical Sciences, Hamandan, Iran
| | - Leila Gholami
- Department of Periodontology, Hamadan University of Medical Sciences, Hamandan, Iran
| | | | - Reza Fekrazad
- Radiation Sciences Research Center, Laser Research Center in Medical Sciences, AJA University of Medical Sciences, Tehran, Iran.,International Network for Photo Medicine and Photo Dynamic Therapy (INPMPDT), Universal Scientific Education and Research Network (USERN), Tehran, Iran
| |
Collapse
|
13
|
Marto CM, Baptista Paula A, Nunes T, Pimenta M, Abrantes AM, Pires AS, Laranjo M, Coelho A, Donato H, Botelho MF, Marques Ferreira M, Carrilho E. Evaluation of the efficacy of dentin hypersensitivity treatments—A systematic review and follow‐up analysis. J Oral Rehabil 2019; 46:952-990. [DOI: 10.1111/joor.12842] [Citation(s) in RCA: 35] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/08/2019] [Revised: 05/20/2019] [Accepted: 06/09/2019] [Indexed: 11/30/2022]
Affiliation(s)
- Carlos Miguel Marto
- Institute of Integrated Clinical Practice, Faculty of Medicine University of Coimbra Coimbra Portugal
- Institute for Clinical and Biomedical Research (iCBR), Area of Environment, Genetics and Oncobiology (CIMAGO), Faculty of Medicine University of Coimbra Coimbra Portugal
- CNC.IBILI University of Coimbra Coimbra Portugal
- Experimental Pathology Institute, Faculty of Medicine University of Coimbra Coimbra Portugal
| | - Anabela Baptista Paula
- Institute of Integrated Clinical Practice, Faculty of Medicine University of Coimbra Coimbra Portugal
- Institute for Clinical and Biomedical Research (iCBR), Area of Environment, Genetics and Oncobiology (CIMAGO), Faculty of Medicine University of Coimbra Coimbra Portugal
- CNC.IBILI University of Coimbra Coimbra Portugal
| | - Tiago Nunes
- Institute of Integrated Clinical Practice, Faculty of Medicine University of Coimbra Coimbra Portugal
| | - Miguel Pimenta
- Institute of Integrated Clinical Practice, Faculty of Medicine University of Coimbra Coimbra Portugal
| | - Ana Margarida Abrantes
- Institute for Clinical and Biomedical Research (iCBR), Area of Environment, Genetics and Oncobiology (CIMAGO), Faculty of Medicine University of Coimbra Coimbra Portugal
- CNC.IBILI University of Coimbra Coimbra Portugal
- Biophysics Institute, Faculty of Medicine University of Coimbra Coimbra Portugal
| | - Ana Salomé Pires
- Institute for Clinical and Biomedical Research (iCBR), Area of Environment, Genetics and Oncobiology (CIMAGO), Faculty of Medicine University of Coimbra Coimbra Portugal
- CNC.IBILI University of Coimbra Coimbra Portugal
- Biophysics Institute, Faculty of Medicine University of Coimbra Coimbra Portugal
| | - Mafalda Laranjo
- Institute for Clinical and Biomedical Research (iCBR), Area of Environment, Genetics and Oncobiology (CIMAGO), Faculty of Medicine University of Coimbra Coimbra Portugal
- CNC.IBILI University of Coimbra Coimbra Portugal
- Biophysics Institute, Faculty of Medicine University of Coimbra Coimbra Portugal
| | - Ana Coelho
- Institute of Integrated Clinical Practice, Faculty of Medicine University of Coimbra Coimbra Portugal
- Institute for Clinical and Biomedical Research (iCBR), Area of Environment, Genetics and Oncobiology (CIMAGO), Faculty of Medicine University of Coimbra Coimbra Portugal
- CNC.IBILI University of Coimbra Coimbra Portugal
| | - Helena Donato
- Documentation Department Coimbra Hospital University Centre Coimbra Portugal
| | - Maria Filomena Botelho
- Institute for Clinical and Biomedical Research (iCBR), Area of Environment, Genetics and Oncobiology (CIMAGO), Faculty of Medicine University of Coimbra Coimbra Portugal
- CNC.IBILI University of Coimbra Coimbra Portugal
- Biophysics Institute, Faculty of Medicine University of Coimbra Coimbra Portugal
| | - Manuel Marques Ferreira
- Institute for Clinical and Biomedical Research (iCBR), Area of Environment, Genetics and Oncobiology (CIMAGO), Faculty of Medicine University of Coimbra Coimbra Portugal
- CNC.IBILI University of Coimbra Coimbra Portugal
- Institute of Endodontics, Faculty of Medicine University of Coimbra Coimbra Portugal
| | - Eunice Carrilho
- Institute of Integrated Clinical Practice, Faculty of Medicine University of Coimbra Coimbra Portugal
- Institute for Clinical and Biomedical Research (iCBR), Area of Environment, Genetics and Oncobiology (CIMAGO), Faculty of Medicine University of Coimbra Coimbra Portugal
- CNC.IBILI University of Coimbra Coimbra Portugal
| |
Collapse
|
14
|
Mir M, Mojahedi SM, Tunér J, Shabani M, Darabi F, Rohban A. The effectiveness of home-use photobiomodulation toothbrush for treating dentin hypersensitivity: A pilot study. Laser Ther 2019; 28:193-198. [PMID: 32009733 DOI: 10.5978/islsm.28_19-or-16] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/21/2019] [Accepted: 05/21/2019] [Indexed: 11/06/2022]
Abstract
Background and Aims Dentin hypersensitivity is a frequent oral condition among patients suffering from gingival recession. Recent studies have suggested that photobiomodulation has the potential to reduce inflammation and relieve pain. The present study aims to assess the effectiveness of a new design of photobiomodulation toothbrush with specific irradiation parameters as a homecare device in treating dentin hypersensitivity and to compare its therapeutic effect with that of fluoride varnish. Materials and Methods Thirty patients with gingival recession and dentin hypersensitivity were selected and randomly assigned to three groups of equal size: fluoride varnish, photobiomodulation, and the combination. Dentin pain and hypersensitivity were measured using visual analog scale (VAS) by two distinct tests: the contact test with a periodontal probe and the air blast test on the areas of gingival recession and denuded root; once at baseline and again one month after the initial application of treatments. Laser irradiation was carried out at the wavelength of 660 nm in CW with an output power of 40 mW for 30 seconds per spot (1.2 J per spot, 6 J/cm2 energy density, and 200 mW/cm2 power density), perpendicularly to denuded root surfaces in non-contact mode. Results A significant reduction in dentin pain and hypersensitivity was observed in all three groups. However, the reduction was significantly greater in the combination group. Conclusion At-home treatment of dentin hypersensitivity with photobiomodulation toothbrush is a convenient, safe, and effective method for the management of dentin hypersensitivity.
Collapse
Affiliation(s)
- Maziar Mir
- DDS, MSc. Alumnus, RWTH Hospital, Aachen, Germany.
| | - Seyed Masoud Mojahedi
- DDS, Ph.D. Department of Laser, School of Dentistry, Shahid Beheshti University of Medical Sciences, Tehran, Iran.
| | - Jan Tunér
- DDS, PhotoBioModulation Consultant, Sollentuna, Sweden.
| | - Masoud Shabani
- DDS, MSc. Department of Community Dentistry, School of Dentistry, Ardabil University of Medical Sciences, Ardabil, Iran.
| | - Fatemeh Darabi
- Ph.D. Department of Public Health, Asadabad School of Medical Sciences, Asadabad, Iran.
| | - Alireza Rohban
- M.Sc. Department of Rehabilitation Management, School of Rehabilitation Sciences, Iran University of Medical Sciences, Tehran, Iran.
| |
Collapse
|
15
|
Rezazadeh F, Dehghanian P, Jafarpour D. Laser Effects on the Prevention and Treatment of Dentinal Hypersensitivity: A Systematic Review. J Lasers Med Sci 2018; 10:1-11. [PMID: 31360362 DOI: 10.15171/jlms.2019.01] [Citation(s) in RCA: 30] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/13/2022]
Abstract
Introduction: Dentinal hypersensitivity (DH) is an acute intensive tooth pain which can lead to dental annoyances during eating and drinking. Stimulating exposed dentinal tubules by either kind of thermal, tactile, chemical and/or osmotic stimuli is believed to be the cause of this pain. It is hypothesized that dentinal tubules' orifice occlusion (DOO) can help relieve such dental irritations. Thus, this systematic review was conducted to evaluate the effectiveness of laser application as a prevention and treatment modality on DH reduction. Methods: Electronic databases (MEDLINE, SCOPUS) were searched among randomized clinical trials from January 2007 to December 2016. The extraction of data and quality assessments were carried out by different independent observers. Results: A total of 499 items were found of which3 9 relevant articles were extracted. The profound findings proved lasers' effectiveness as a treatment of DH. Although some of the researches reported no significant difference between laser and other desensitizing agents, most of the studies suggested that better results (both rapid and long-lasting) were obtained in combined modalities. Furthermore, the preventive role of this new technology has been emphasized as well. Nd-YAG (neodymium-doped yttrium aluminum garnet) and diode lasers reduce DH after bleaching. Lasers can also protect cervical restorations from DH due to tubular occlusion. Moreover, it is suggested to apply lasers in relief of DH following scaling and root planning. Nevertheless, a few researchers dispute its beneficence as a result of placebo effect. Conclusion: The results obtained from several studies in the present review revealed that the application of lasers is effective not only in terms of treatment of DH, but also in the prevention of this intensive tooth pain. Among various types of lasers, the application of Nd:YAG laser has shown the best results in DH treatment.
Collapse
Affiliation(s)
- Fahimeh Rezazadeh
- Oral and Dental Disease Research Center, Oral & Maxillofacial Medicine department, School of Dentistry, Shiraz University of Medical Sciences, Shiraz, Iran
| | - Paria Dehghanian
- Student Research Committee, School of Dentistry, Shiraz University of Medical Sciences, Shiraz, Iran
| | - Dana Jafarpour
- Research Associate, Biomaterials Research Center, School of Dentistry, Shiraz University of Medical Sciences, Shiraz, Iran
| |
Collapse
|
16
|
Machado AC, Viana ÍEL, Farias-Neto AM, Braga MM, de Paula Eduardo C, de Freitas PM, Aranha ACC. Is photobiomodulation (PBM) effective for the treatment of dentin hypersensitivity? A systematic review. Lasers Med Sci 2017; 33:745-753. [DOI: 10.1007/s10103-017-2403-7] [Citation(s) in RCA: 19] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/05/2017] [Accepted: 11/28/2017] [Indexed: 10/18/2022]
|
17
|
Cury MS, Silva CB, Nogueira RD, Campos MGD, Palma-Dibb RG, Geraldo-Martins VR. Surface roughness and bacterial adhesion on root dentin treated with diode laser and conventional desensitizing agents. Lasers Med Sci 2017; 33:257-262. [PMID: 29032514 DOI: 10.1007/s10103-017-2356-x] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/08/2017] [Accepted: 10/06/2017] [Indexed: 11/30/2022]
Abstract
The treatments for dentin hypersensitivity (DH) may change the surface roughness of the root dentin, which can lead to biofilm accumulation, increasing the risk of root caries. The aim was to compare the surface roughness of root dentin after different treatments of DH and the biofilm formation on those surfaces. After initial surface roughness (Sa) assessment, 50 bovine root fragments received the following treatments (n = 10): G 1-no treatment; G2-5% sodium fluoride varnish; G3-professional application of a desensitizing dentifrice; G4-toothbrushing with a desensitizing dentifrice; and G5-diode laser application (908 nm; 1.5 W, 20 s). The Sa was reevaluated after treatments. Afterward, all samples were incubated in a suspension of Streptococcus mutans at 37 °C for 24 h. The colony-forming units (CFU) were counted using a stereoscope, and the results were expressed in CFU/mL. The one-way ANOVA and the Tukey's tests compared the roughness data and the results obtained on the bacterial adhesion test (α = 5%). G2 (2.3 ± 1.67%) showed similar Sa variation than G1 (0.25 ± 0.41%) and G5 (5.69 ± 0.99%), but different from group G3 (9.05 ± 2.39%). Group 4 showed the highest Sa variation (30.02 ± 3.83%; p < 0.05). Bacterial adhesion was higher in G4 (2208 ± 211.9), suggesting that bacterial growth is greater on rougher surfaces. The diode laser and the conventional treatments for DH may change the surface roughness of the root dentin, but only brushing with desensitizing dentifrice induced a higher bacteria accumulation on root dentin surface.
Collapse
Affiliation(s)
- Maiza S Cury
- Department of Clinical Dentistry, School of Dentistry, Uberaba University, Av. Nene Sabino, 1801 Sala 2D04, Uberaba, MG, 38 055 500, Brazil
| | - Camilla B Silva
- Biopathology Division, Uberaba University, Av. Nene Sabino, 1801 Sala 2D04, Uberaba, MG, 38 055 500, Brazil
| | - Ruchele D Nogueira
- Biopathology Division, Uberaba University, Av. Nene Sabino, 1801 Sala 2D04, Uberaba, MG, 38 055 500, Brazil
| | - Michelle G D Campos
- Department of Clinical Dentistry, School of Dentistry, Uberaba University, Av. Nene Sabino, 1801 Sala 2D04, Uberaba, MG, 38 055 500, Brazil
| | - Regina G Palma-Dibb
- Department of Restorative Dentistry, Ribeirao Preto Dental School, São Paulo University, Avenida do Cafe, s/n, Ribeirao Preto, SP, 14040 904, Brazil
| | - Vinicius R Geraldo-Martins
- Department of Clinical Dentistry, School of Dentistry, Uberaba University, Av. Nene Sabino, 1801 Sala 2D04, Uberaba, MG, 38 055 500, Brazil.
| |
Collapse
|
18
|
Gojkov-Vukelic M, Hadzic S, Zukanovic A, Pasic E, Pavlic V. Application of Diode Laser in the Treatment of Dentine Hypersensitivity. Med Arch 2016; 70:466-469. [PMID: 28210023 PMCID: PMC5292213 DOI: 10.5455/medarh.2016.70.466-469] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/25/2016] [Accepted: 12/15/2016] [Indexed: 11/03/2022] Open
Abstract
INTRODUCTION Dentine hypersensitivity is characterized by acute, sharp pain arising from the exposed dentine, most commonly in response to thermal, tactile, or chemical stimuli, and which cannot be linked to any other pathological changes in the tooth or the environment. Therapy uses various impregnating agents in the form of solutions or gels and, in more recent times, laser. AIM The aim of this research was to examine the effects of treatment of hypersensitive dental cervix with diode laser. MATERIALS AND METHODS The study included 18 patients with 82 sensitive teeth. The degree of dentine hypersensitivity was evaluated by visual analogue scale (VAS), and the treatment was carried out by application of low-power diode laser over the span of three visits, which depended on the initial sensitivity. RESULTS There is a significant difference in VAS values measured at the onset of treatment (baseline) and immediately after the first laser treatment (t=9.275; p=0.000), after 7 days, after the second laser treatment (14 days) (t=7.085, p=0.000), as well as after 14 days and the third laser treatment (t=5.517, p=0.000), which confirms the effectiveness of this therapeutic procedure. The results showed a reduction of hypersensitivity in response to tactile stimulus with a probe after the third treatment, even with teeth whose value on the VAS was very high at the beginning of treatment (baseline). CONCLUSION Within the scope of the conducted study, laser therapy has provided extremely safe and effective results in the treatment of cervical dentine hypersensitivity.
Collapse
Affiliation(s)
- Mirjana Gojkov-Vukelic
- Department of Oral Medicine and Periodontology, Faculty of Dentistry, University of Sarajevo, Bosnia and Herzegovina
| | - Sanja Hadzic
- Department of Oral Medicine and Periodontology, Faculty of Dentistry, University of Sarajevo, Bosnia and Herzegovina
| | - Amila Zukanovic
- Department of Pediatric Dentistry, Faculty of Dentistry, University of Sarajevo, Bosnia and Herzegovina
| | - Enes Pasic
- Department of Oral Medicine and Periodontology, Faculty of Dentistry, University of Sarajevo, Bosnia and Herzegovina
| | - Veriva Pavlic
- Department of Periodontology and Oral Medicine, Institute of Dentistry, Banja Luka, Bosnia and Herzegovina
| |
Collapse
|